My Therapy Dog

This is Inge. As you can tell, she's just a puppy now, and I'm going to go pick her up next week. Many of you know that I already have cats, whom I love to pieces, and I thought long and hard about getting a dog, even one as cute as Inge is.

But the more I thought about it, the more I realized that having a dog will be good for me. Of course, I'm aware that as a baby, she will require a lot of care and training, and I'm reading up at length about what items I will need to take care of her, and what her training needs will be. I've also taken steps to make sure the cats have safe places to be dog-free, and that she will not be able to get into their food dishes or litter boxes.

But here's what she's going to do for me: she's going to take me for walks. Since she will always be little, I won't have to go galloping after her, and she won't need to go 10 miles at a time, but she will walk at a nice pace around the block a time or two when she's fully grown, and I will go with her. Or we'll go to a park and walk around the park (there is a nice one not too far from me). I also have a yard, and we can play fetch in the yard, and I will be able to get some sunshine to boost my levels of vitamin D. In the summer, we will go in the cool of the morning or evening, and in the winter, we'll go in the middle of the day, when it's warmest. It will be good for me, because I have a hard time motivating myself to walk on my own, but having a little pal to walk with will make all the difference, because I feel very responsible for my animals. Knowing that she needs the exercise and will be eager to go will motivate me in a way that I haven't been able to do for myself. Thus the concept of Inge as therapy dog.

And best of all, she'll reward me with cuddles when I need them. I think it will be a good deal for both of us! :-)

Evaluating studies from a patient perspective

I just read a report about a study which said that major weight loss had no effect on cardiovascular disease in T2s, but of course, they should lose weight anyway. That kind of qualifier seems to be required in studies that show results contrary to received knowledge. Why couldn't they have just said weight loss had no effect on CV disease in T2s, and skipped the part about weight loss?

I think this involves assessing just what the relationship between doctor and patient should be. For example, a hypothetical patient with T2 might have metabolic syndrome adequately controlled by meds, no other comorbid conditions, and not be able to lose weight. So his CV risk factors are being controlled and there is no reason I can see to nag him to lose weight.

Another article I saw found no fault with a doctor publicly stating NJ governor Chris Christie was too morbidly obese to be president (not advocating any personal political stance here), because of his risk for CV disease. But, in fact, she knows nothing about his personal risk factors, and I think she had no business calling him out on it. Not to speak of the fact that other presidential candidates have had high-risk health problems, too.

Then there is the study in another thread about carb counting in T1s. Our overwhelming consensus on TuDiabetes (http://www.tudiabetes.org) is that it does help, even though the study concluded that there is no difference from "usual care", whatever that means.

So what is perturbing to me is that these kind of studies and opinions devalue the insights of the person into their own health status, as if we were totally unaware of our health risks and what we want to prioritize. They talk about involving patients in their own care, but then dismiss our experiences and wisdom.

I think this is a major way in which medical care needs to evolve.